Transcatheter Arterial Embolization with N-Butyl-2-cyanoacrylate for Pancreatic and Surrounding Tissue Bleeding

N-Butyl-2-cyanoacrylate (NBCA) has been widely used for transcatheter arterial embolization (TAE) of acute arterial hemorrhages and aneurysms. Compare to conventional TAE with coils and gelatin sponges, the TAE using NBCA (NBCA-TAE) is more easily applicable in small and tortuous vascular anatomies, associated with a lower risk of recurrent bleeding after successful intervention. Furthermore, the presence of coagulopathy does not affect the physiologic hemostasis effect of NBCA. Thus, bleeding in the pancreas and surrounding tissues, including pseudoaneurysms complicating pancreatitis or pancreatectomy, pancreatic cancer and duodenal ulcer, can be favorably treated with NBCA-TAE. This review describes methods, clinical outcomes and safety of NBCA-TAE for managing acute bleeding of pancreas and its surrounding tissues based on a single-center experience and results of animal experimentation.